SUSAN JACKSON
NPI 1629402995
Counselor - Professional in Philadelphia, PA
About Susan Jackson NPPES
Official registry information on file with the National Plan and Provider Enumeration System.
SUSAN JACKSON (NPI 1629402995) is an individual professional provider in Philadelphia, Pennsylvania and active in the NPI registry since August 2013. She is enrolled in Medicare PECOS and is a graduate of Other (2013).
NPPES Registry Identity
Specialties & Licenses
Medicare Participation & PECOS CMS
Medicare enrollment, assignment, billing reassignment, and ordering and referring status from CMS.
Medicare Enrollment Status
Enrolled in Medicare and accepts Medicare assignment
Susan Jackson is registered in PECOS and agrees to accept the Medicare-approved amount as full payment. Medicare patients are not billed beyond the standard deductible and coinsurance.
Medicare Billing Reassignment
Medicare enrollment records show Susan Jackson reassigns Medicare billing to 1 organization. The organization bills Medicare for the services this provider delivers there.
Philadelphia, PA 19124
- Reassigned Medicare billing, Pennsylvania enrollment
- 232 clinicians in this Medicare group
Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.
Other Providers at the Same Location NPPES 20
Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.
Frequently Asked Questions NPPES & CMS
Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.
What is Susan Jackson's NPI number?
The NPI number for Susan Jackson is 1629402995. It was assigned to this individual provider in the NPPES registry on August 22, 2013.
Where is Susan Jackson located?
Susan Jackson practices at 4510 Frankford Ave 2nd Floor, Philadelphia, PA 19124. The listed phone number is (215) 744-1302.
What is Susan Jackson's specialty?
The primary specialty registered for this NPI is Counselor, specializing in Professional, with taxonomy code 101YP2500X.
Is Susan Jackson enrolled in Medicare?
Yes. Susan Jackson is registered in the Medicare PECOS system and accepts Medicare assignment, which means accepting the Medicare-approved amount as payment in full for covered services.
Which organization bills Medicare for Susan Jackson's services?
According to the CMS Revalidation Reassignment List (October 2026 release), Susan Jackson reassigns Medicare benefits to Greater Philadelphia Health Action Inc. (Philadelphia, PA). The reassignment is filed with Medicare on form CMS-855R, signed by both the clinician and the organization, and lets the organization bill Medicare and receive payment for Susan Jackson's services. Reassignment records can lag staffing changes; confirm current arrangements with the organization.
When was this NPI record last updated?
The NPPES record for Susan Jackson was last updated on August 22, 2013. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 13 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.
# Susan Jackson · NPI 1629402995
Professional provider in Philadelphia, Pennsylvania. Individual provider, active in the CMS NPPES registry since August 22, 2013.
## Identity
- **NPI:** 1629402995 (Entity type: Individual)
- **Enumerated:** August 22, 2013
- **Primary specialty:** Counselor - Professional · taxonomy 101YP2500X
- **Sole proprietor:** No
## Practice location
- **Address:** 4510 FRANKFORD AVE, 2ND FLOOR, Philadelphia, PA 19124-3602
- **Phone:** (215) 744-1302 · **Fax:** (215) 744-2544
## Medicare
- **Medicare:** Enrolled (PECOS); accepts Medicare assignment
- **Ordering & referring:** eligible for Part B labs & imaging, durable medical equipment
- **Bills Medicare through:** Greater Philadelphia Health Action Inc. (NPI 1659325652, Philadelphia, PA), under Medicare reassignment (form CMS-855R) · CMS Revalidation Reassignment List, October 2026 release
- **Medical school:** Other, class of 2013
## Record status
- **NPPES last updated:** August 22, 2013
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Source: [NPI Profile](https://npiprofile.com/npi/1629402995) · Data from the CMS NPPES public registry.